Provider Demographics
NPI:1538742655
Name:MARRERO ROSADO, LEYSHLA MARIE
Entity type:Individual
Prefix:
First Name:LEYSHLA
Middle Name:MARIE
Last Name:MARRERO ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB COLINAS DE SAN FRANCISCO
Mailing Address - Street 2:50 CALLE LUCERO
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:787-315-3783
Mailing Address - Fax:
Practice Address - Street 1:URB COLINAS DE SAN FRANCISCO
Practice Address - Street 2:50 CALLE LUCERO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-315-3783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13302183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician